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The link between prenatal maternal smoking and sudden infant death syndrome (SIDS) is well established, but an association with maternal alcohol use is less clear. In this prospective longitudinal cohort study, researchers examined potential effects and interactions of exposure to both substances on 12,029 fetuses in Cape Town, South Africa, and two American Indian reservations, locales with high rates of alcohol use and SIDS. Pregnant women were enrolled between 6 weeks' gestation and delivery and completed up to three additional prenatal visits. Mothers and their infants were then assessed at delivery, 1 month, and 1 year. All postdischarge infant deaths were investigated. Self-reported smoking and alcohol use were classified as none or q…